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Overcrowding continues to afflict emergency departments (EDs), and its attendant consequences are becoming increasingly severe. The burden of the COVID-19 pandemic is further escalating the situation worldwide. One of the most critical questions is how to adequately quantify what constitutes overcrowding and determine implications for operations management in improving service efficiency. This paper aims to discuss the aforementioned.

The authors propose the time and class complexity measures for ED service systems, taking into account important patient-level and system characteristics. Using an extensive data set from a Canadian ED, the authors investigate the performance of complexity-based measures in predicting service delays.

The authors find that the complexity measure is potentially more important than some well-known crowding metrics. In particular, EDs can improve service efficiency by managing the level of complexity within a desirable interval. Furthermore, complexity exposes how the interplay between demand-side behavioral changes and supply-side responses affects operational performance. Moreover, the results suggest that arrival patterns—the number of patients of each class arriving per time and times between events (arrivals and service completions)—increase the risk of service delays more than the demand volume.

This paper is the first to provide an extensive investigation into the application of the complexity-based measure for ED crowding. The study demonstrates potential values to be gained in ED service systems if complexity measure is incorporated into their operations management decisions.

Vehicle allocation problems (VAPs), which are frequently confronted in many transportation activities, primarily including but not limited to full truckload freight transportation operations, induce a significant economic impact. Despite the increasing academic attention to the field, literature still fails to match the needs of and opportunities in the growing industrial practices. In particular, the literature can grow upon the ideas on sustainability, Industry 4.0 and collaboration, which shape future practices not only in logistics but also in many other industries. This review has the potential to enhance and accelerate the development of relevant literature that matches the challenges confronted in industrial problems. Furthermore, this review can help to explore the existing methods, algorithms and techniques employed to address this problem, reveal directions and generate inspiration for potential improvements.

This study provides a literature review on VAPs, focusing on quantitative models that incorporate any of the following emerging logistics trends: sustainability, Industry 4.0 and logistics collaboration.

In the literature, sustainability interactions have been limited to environmental externalities (mostly reducing operational-level emissions) and economic considerations; however, emissions generated throughout the supply chain, other environmental externalities such as waste and product deterioration, or the level of stakeholder engagement, etc., are to be monitored in order to achieve overall climate-neutral services to the society. Moreover, even though there are many types of collaboration (such as co-opetition and vertical collaboration) and Industry 4.0 opportunities (such as sharing information and comanaging distribution operations) that could improve vehicle allocation operations, these topics have not yet received sufficient attention from researchers.

The scientific contribution of this study is twofold: (1) This study analyses decision models of each reviewed article in terms of decision variable, constraint and assumption sets, objectives, modeling and solving approaches, the contribution of the article and the way that any of sustainability, Industry 4.0 and collaboration aspects are incorporated into the model. (2) The authors provide a discussion on the gaps in the related literature, particularly focusing on practical opportunities and serving climate-neutrality targets, carried out under four main streams: logistics collaboration possibilities, supply chain risks, smart solutions and various other potential practices. As a result, the review provides several gaps in the literature and/or potential research ideas that can improve the literature and may provide positive industrial impacts, particularly on how logistics collaboration may be further engaged, which supply chain risks are to be incorporated into decision models, and how smart solutions can be employed to cope with uncertainty and improve the effectiveness and efficiency of operations.